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Osteoporosis in women: keeping your bones healthy and strong.

What is osteoporosis?

In osteoporosis, the bones become porous and thin. Over time, this weakens the bones and may make them more likely to break.

Osteoporosis is much more common in women than in men. This is because women have less bone mass than men, tend to live longer and take in less calcium, and need the female hormone estrogen to keep their bones strong. If men live long enough, they are also at risk of getting osteoporosis later in life.

Once total bone mass has peaked--around age 35--all adults start to lose it. In women, the rate of bone loss speeds up during menopause, when they quit making estrogen. Bone loss also may occur if both ovaries are removed by surgery.

What are the signs of osteoroposis?

You may not know you have osteoporosis until you have serious signs. Signs include a broken wrist or hip, low back pain or a hunched back. You may lose some of your height over time, because osteoporosis can cause the bones in your spine to collapse. These are called compression fractures and can cause severe back pain. These problems can occur after a lot of bone calcium has been lost.

What increases the change of getting osteoporosis?

To the right is a list of things that put you at risk for osteoporosis. The more of these that apply to you, the higher your risk is. Talk to your family doctor if you think you may be at risk for osteoporosis.

Does hormone treatment prevent osteoporosis?

Hormone replacement therapy is one of the best ways to keep osteoporosis from getting worse once it has started. If you begin hormone replacement therapy at the time of menopause, it can help prevent osteoporosis from happening at all. In replacement therapy, you take hormones, such as estrogen and progestin, that your body stops making at menopause or if your ovaries are removed by surgery.

What are the benefits of hormone treatment?

Estrogen keeps your bones from losing calcium and can help your bones stay strong. Broken bones, a loss in height and other signs of osteoporosis can all be prevented. Taking estrogen will also treat signs of menopause, like hot flashes and vaginal dryness. It may also help protect you against heart disease and reduce your risk of ovarian cancer. If the hormone progestin is taken with estrogen, hormone treatment may also decrease the risk of endometrial cancer (cancer of the lining of the uterus).

What are the side effects of hormones?

Side effects of estrogen may include sore breasts, the return of menstrual periods, slight bleeding between periods, weight gain and gallstones. The risk of breast cancer may or may not be increased. Your breasts may get lumpy.

If you take estrogen without progestin, you may be at greater risk of endometrial cancer. Progestin offsets this risk. This is why your doctor may prescribe progestin for you (if you have not had your uterus removed).

Should I have special tests done if I take hormones?

Your doctor may want you to have a mammogram to watch for changes in your breasts. Pap smears should also be done annually. Some doctors also check the lining of the uterus for cancer with a procedure called endometrial sampling.

During endometrial sampling, cells from inside the uterus are gathered with a very thin instrument. Your doctor may do this before starting you on replacement therapy or if you have unusual vaginal bleeding while on therapy.

When should I start taking hormones?

Hormones can be started during menopause or any time after menopause. Your doctor may also start you on them if you have had surgery to remove your ovaries. It is usually best to start hormone treatment as soon as possible. You will get the most benefit if you start taking hormones within a year after menopause and within three years after your last period.

How long will I have to take hormones?

As soon as you stop replacement therapy, your bones start to lose calcium. Symptoms of menopause also return. The longer you take replacement therapy, the less likely you will get osteoporosis.

Should I also take calcium?

It is usually best to try to get the calcium you need from food. Sometimes, women don't eat enough dairy products because they think these foods are too fattening. But dairy products made from skim milk have as much calcium as those made from whole milk. Non-dairy sources of calcium include dried beans, sardines and broccoli.

Women need about 1,000 mg of calcium a day before menopause. The same amount is needed after menopause if you're on estrogen. Up to 1,500 mg of calcium a day is needed after menopause if you're not taking estrogen. About 300 mg of calcium is provided in each of the following foods: 1 cup of milk or yogurt, two cups of broccoli, or six to seven sardines.

Your doctor may suggest that you take a calcium pill if you don't get enough calcium from the food you eat. It's usually best to take the form of calcium called calcium carbonate because it seems to be easier than the other forms for the body to use. Take it at meal time or with a sip of milk. Vitamin D and lactose (the natural sugar in milk) help your body absorb the calcium.

Risk factors for osteoporosis

* Menopause before age 48

* Surgery to remove ovaries before normal menopause

* Not getting enough calcium in your food

* Not getting enough exercise

* Smoking

* Osteoporosis in your family

* Alcohol abuse

* Small bone frame

* Thin

* Fair skin (Caucasian or Asian race)

* Hyperthyroidism

* Use of steroids

Tips to keep bones strong and to avoid falls

* Exercise.

* Eat a normal, well-balanced diet.

* Don't use throw rugs in your home. They can trip you.

* Wear flat, rubber-soled shoes.

* Use a cane or walker if you need to.

* Put hand grips and safety mats in your tub or shower.

* Be sure stairways are well lit.

* Don't stoop to pick up things. Pick up things by bending your knees and keeping your back straight.

* Quit smoking. Smoking makes osteoporosis worse and may cancel out the benefits of estrogen replacement therapy.

For more information, call the National Osteoporosis Foundation at 202-223-2226.

This brochure provides a general overview on this topic and may not apply to everyone. To find out if this brochure applies to you and to get information on this subject, talk to your family doctor.
COPYRIGHT 1992 American Academy of Family Physicians
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1992 Gale, Cengage Learning. All rights reserved.

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Publication:Pamphlet by: American Academy of Family Physicians
Article Type:Pamphlet
Date:Jan 1, 1992
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